Study of general practitioner consultations for tick bites at high, medium and low incidence areas for Lyme borreliosis in England and Wales

Gillingham, EL; Hall, JL; Birtles, RJ; Bown, K; Medlock, JM; Smith, R; Hansford, KM; Warner, JC; Dryden, M; Pietzsch, ME

Abstract

Lyme borreliosis (LB) is a tick‐borne disease caused by Borrelia burgdorferi sensu lato complex. In Europe, it is predominately transmitted by the sheep tick, Ixodes ricinus. Compared with other European countries, the United Kingdom (UK) is considered to have a low incidence of LB, although this varies regionally. To determine whether an association exists between tick bite consultations and LB incidence in the UK, retrospective questionnaires were sent to general practitioners (GPs) in high (Wiltshire), medium (Cumbria) and low (Wales) incidence areas. During 2011, the greatest incidence of consultations for tick bites was reported by GPs in Cumbria (204 consultations per 100,000 inhabitants), followed by Wiltshire (160 per 100,000 population) and Wales (54 per 100,000 population). In Wiltshire and Cumbria, GPs predominantly provided advice on tick removal, whilst Welsh GPs mostly advised patients on tick bite prevention. Focusing on Cumbria during 2011–2013, 72.5% of GPs removed ticks from patients (incidence of 101 consultations per 100,000 population), and more GPs diagnosed LB based on clinical features than laboratory‐confirmed diagnoses. To date, this is the first study to investigate the incidence of tick bite consultations and LB in England and Wales.

• Journal Article Type: Article
• Acceptance Date: Feb 5, 2020
• Online Publication Date: Mar 11, 2020
• Publication Date: Jul 16, 2020
• Deposit Date: Apr 28, 2020
• Publicly Available Date: Mar 11, 2021
• Journal: Zoonoses and Public Health
• Print ISSN: 1863-1959
• Electronic ISSN: 1863-2378
• Publisher: Wiley
• Volume: 67
• Issue: 5
• Pages: 591-599
• DOI: https://doi.org/10.1111/zph.12694
• Keywords: Public Health, Environmental and Occupational Health, General Immunology and Microbiology, Epidemiology, General Veterinary, Infectious Diseases
• Publisher URL: https://doi.org/10.1111/zph.12694
• Related Public URLs: http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1863-2378
• Additional Information: Additional Information : ** Article version: VoR ** From Crossref via Jisc Publications Router **Journal IDs: pissn 1863-1959; eissn 1863-2378 **History: issued 11-03-2020; published_online 11-03-2020 **License for this article: starting on 11-03-2020, , http://onlinelibrary.wiley.com.salford.idm.oclc.org/termsAndConditions#vor; Access Information : This is the peer reviewed version of the following article: Gillingham, EL, Hall, JL, Birtles, RJ, et al. Study of general practitioner consultations for tick bites at high, medium and low incidence areas for Lyme borreliosis in England and Wales. Zoonoses Public Health. 2020; 00: 1– 9., which has been published in final form at https://doi.org/10.1111/zph.12694. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.